1. Brain Functional Connectivity Significantly Improves After Surgical Eradication of Porto-Systemic Shunting in Pediatric Patients
- Author
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Gianvincenzo Sparacia, Giuseppe Parla, Roberto Miraglia, and Jean de Ville de Goyet
- Subjects
minimal hepatic encephalopathy ,non-cirrhotic portal hypertension ,Abernethy malformation ,Meso-Rex bypass ,magnetic resonance imaging ,resting-state functional magnetic resonance imaging ,Science - Abstract
Purpose: Porto-systemic shunting (PSS) in patients with Abernethy malformation (AM) or obstruction of the portal vein (OVP) is often associated with normal liver parenchyma and hepatic function. This association provides an interesting natural model for studying the brain functional connectivity changes secondary to PSS but independently from hepatic (dys)function. Because PSS can be eliminated with appropriate interventions, these particular conditions offer a unique physio-pathological model where the same patient can be studied in both “active PSS” and “absent PSS” conditions (pre- and post-cure analyses). Methods: Four children (p < 0.05 family-wise error) improvement in global brain functional connectivity in both groups following each surgical procedure. Conclusions: In this clinical model of isolated PSS (with absence of hepatic dysfunction), brain functional connectivity was altered even in young patients and in the absence of hyperammonemia; moreover, specific interventions to cancel out PSS consequently significantly improved brain functional connectivity.
- Published
- 2025
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